Attention Deficit Disorder
Assessment
ADHD is usually suspected during early school years as the core symptoms become problematic. The core symptoms include:
Attention Deficit
Attentional problems are manifest as appearing not to listen, inability to complete tasks, easily distracted, and avoiding tasks requiring sustained mental effort. This leads to a chaotic and disorganised life which requires significant support from others to get through day to day tasks and challenges.
Impulsivity
Impuslivity is to react prior to considering the result of such actions. Calling out, inablity to wait turns, interrupting, lashing out, are some of the examples. This can lead to dangerous behaviour where consequences are not considered before action. For example running onto a road when chasing a ball.
Hyperactivity
Hyperactivity is the most understood
- Is in constant motion, as if “driven by a motor”
- Cannot stay seated
- Frequently squirms and fidgets
- Talks too much
- Often runs, jumps, and climbs when this is not permitted
- Cannot play quietly
Diagnosis
Paediatricians and specialists in this field should be the only health care providers who make the correct diagnosis. Evidence is collected from the parents and the school and these look at attention, hyperactivity and impulsivity. (This last can best be thought of as acting without thinking). The path to diagnosis should involve several consultations and consider other factors that affect a child’s attention span such as learning disabilities, sensory impairments, chronic illness, developmental disorders, parenting and family stressors and child abuse and neglect. All these conditions can lead to some of the symptoms of ADD. What is hard is that many of these factors will be in play even when it is clear the child has ADD. Correcting some of these is part of the treatment.
Treatment
Once the diagnosis is made the treatment is two fold. The first involves correcting some of the parenting strategies that may have unwittingly contributed to the condition and the second is the controversial area of medication.
There is absolutely no doubt that some children with ADD respond quickly and dramatically to the medication. In some instances it is like turning on a switch. It results in a calmer more functional child who is able to complete tasks and perform successful day-to-day activities. Often their writing is clearer they appear calmer and the beauty of all this is that people actually start to like them. Their self – esteem improves and they are happier. This is not universal and the medications involved do not cure. All they do is control. They are non addictive and the main side effects are loss of appetite and insomnia.
The long-term outcome is not clear. Some types of ADD persist into adult hood and although many of the symptoms settle it is clear the adolescent and adult still have the impulsivity and inattention. Those who have no other associated diagnosis and have a reasonable degree of intelligence will improve and can become leaders in their chosen field.
As with many conditions where there are no specific blood tests or X – rays, where professionals base the diagnosis on history from parents and teachers and observations, there are always going to be children who have been wrongly diagnosed. One of the biggest concerns is that parents and health – providers can be guilty of looking for the quick fix. Therefore poor behaviour or problems at home and school will quickly and wrongly result in medication being used. This has been one of the main concerns in the USA where the use of medications for children’s behaviour has dramatically increased over the last few years. Despite this Australia is not following suit.
All these children will have some special skill. Finding this can often be half the battle. One of the things I tell parents is to list the good qualities as often these have been forgotten. The last thing these children need is ongoing criticism. They need understanding and support and at this stage there is very little of either from our society
